- Sedgwick (Richmond, VA)
- …to support the claim request and documents decision rationale. + Completes medical review of all claims by reviewing medical documentation received ... status. + Provides clear and appropriate follow -up recommendations for ongoing medical management of claims ; ensures appropriate recommendations are made on … more
- Veterans Affairs, Veterans Health Administration (Richmond, VA)
- …timely fashion. All physicians will work within their privileges at all times and follow the Medical Bylaws. Telework: Pending exemption for remote status: Under ... to deliver primary care services to patients in other medical centers. Supervisory level: No, however, the scope of...in an outpatient setting. Provide ongoing outpatient care including follow up of inpatient visits for assigned patients. Screen… more
- GE Aerospace (Glen Allen, VA)
- …eligibility requirements, and limitations + Strong preference for long term care insurance claim experience + Working knowledge of medical terminology and ... In this high-impact role, you'll deliver sharp insights, adjudicate complex claims , and collaborate across teams using advanced analytics and emerging technology.… more
- Seventh Dimension (Richmond, VA)
- …VA patient's wheelchair into their vehicle. + Return VAMC (Veterans Affairs Medical Center) provided wheelchairs to the designated storage location. + Monitor the ... valet parked vehicle drivers on how to check and claim their valet parked vehicles. + Valet Attendant drop...filed to verify parking counts and any potential damage claims . * If the vehicle driver refuses to sign… more
- UNUM (Richmond, VA)
- …Physical Medicine and Rehabilitation. This position is responsible for providing expert medical analysis of claims files (or underwriting applications) across ... and efficient medical consultative services to the Benefits Center. The Medical Consultant adheres to current regulatory, claim process, and internal… more
- Elevance Health (Ashburn, VA)
- …coding or quality assurance environment preferred. + Broad knowledge of medical claims billing/payment systems provider billing guidelines, payer reimbursement ... -expense spending. The **DRG CODING AUDITOR** is responsible for auditing inpatient medical records and generating high quality recoverable claims for the… more
- Cardinal Health (Richmond, VA)
- …Billing leadership teams.** **_Responsibilities_** + Processes claims : investigates insurance claims ; and properly resolves by follow -up & disposition. + ... done. **The Accounts Receivable Specialist II is responsible for processing insurance claims and billing. They will work within the scope of responsibilities as… more
- Elevance Health (Ashburn, VA)
- …+ Coordinates prompt claims resolution through direct contact with providers, claims , pricing and medical management department. + Identifies and reports on ... to: + Researches, analyzes and recommends resolution for contract dispute, non-routine claim issues, billing questions and other practices. + May participate in… more
- University of Virginia (Charlottesville, VA)
- …improvement. + Reviews and resolves charge sessions that fail charge review edits, claim edits and follow -up work queues, identifies areas of opportunity based ... responsibilities depending on their work assignment. + Reviews documentation in medical record to appropriately assign ICD-10-CM, CPT-4, HCPCS and modifiers within… more
- Elevance Health (Norfolk, VA)
- …**Financial Operations Recovery Specialist** is responsible for setting up and adjusting claims overpayments that have been previously identified. May do all or some ... of the following in relation to cash receipts, cash application, claim audits, collections, overpayment vendor validation, and claim adjustments. **How you will… more